Associate, Network Contracting

Hi, we're Oscar. We're hiring a Associate, Network Contracting to join our Network team.

Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

The Associate, Network Contracting is responsible for negotiating and managing contracts with healthcare providers (hospital/health system and individual) to build and maintain a robust network in assigned market/region; while also ensuring access to quality care and optimizing costs by analyzing provider performance and negotiating reimbursement rates, often involving complex contract terms and compliance with regulatory guidelines. The Associate also supports network growth and recruiting efforts by engaging with prospective providers directly; assisting with resolution of provider issues; supporting cost- saving initiatives; assisting with the design and execution of the local network strategy; and ensuring providers across our service area have the information and support they need to provide best-in-class member care.

Travel required up to 15%.

You will report the Manager, Network Contracting.

Work Location:

This is a remote position with travel. You must reside in Florida #LI-Remote

Pay Transparency:

The base pay for this role is $88,560 - $116,235 per. year. You are also eligible for employee benefits, participation in Oscar’s unlimited vacation program and annual performance bonuses. 

Responsibilities

• Implement contracting strategies under the direction of Network Director and/or Senior Manager and in partnership with Market Leaders that align with our overall network adequacy, development and cost management goals.
• Manage and negotiate contracts with assigned healthcare providers, focusing on favorable terms and compliance with organizational standards and regulatory requirements.
• Serve as a Subject Matter Expert to a small team of contracting specialists and/or analysts, providing guidance and encouraging a collaborative and work environment.
• Supports comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization.
• Utilizes data and analytics of provider financial issues and competitor strategies to support informing negotiation and contracting decisions.
• Facilitates guidance and mentorship of more junior team members by reiterating strategic goals, providing training and development opportunities, and promoting a collaborative and work environment.
• Supports implementation of contracting policies and workflows; supports identifying when effective and efficient contracting processes need improvement Meet defined metrics and SLAs including but not limited to provider outreach and contract completion.
• Collaborate with the provider services team regarding the servicing, education and communication to our provider network.
• Monitor assigned networks to gauge compliance with standards, developing corrective action plans with network contracting and market leadership to improve deficiencies.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Qualifications

• 3+ years of experience in healthcare client management, healthcare consulting, or provider healthcare contracting, healthcare operations, or a related field
• 2+ years of experience supporting provider network strategy development and negotiating provider contracts
• 1+ years experience navigating and organizing large data sets such as claim files and provider rosters
• 1+ years experience running financial analyses on a markets or product lines, and working cross-functionally to support improving opportunities
• Able to travel up to 15%.